Abstract [en]

Longitudinal studies exploring sexuality, body image and health-related quality of life (HRQoL) are lacking in patients treated with chemo- or chemoimmuno-therapy for hematologic malignancies. The aim was to describe and explore changes in sexuality, body image and HRQoL in patients treated for hematologic malignancies, from baseline until 6 months after treatment. Twenty patients above 45 years (median age 62) treated for DLBCL, CLL or AML participated. Data were collected at baseline, 1- and 6-months after treatment by means of three instruments: SAQ-S, BIS and EORTC QLQ-C30. The results showed that patients' sexuality was negatively affected 1 month after treatment, but after 6 months the patient reported scores had returned almost entirely to baseline scores. Body image was slight negatively affected after 1 month and after 6 months, 50 % reported that body image was not affected at all. Regarding HRQoL, patients reported gradually improved scores during the study period. Regression analysis showed that changes in sexuality and body image seemed to influence changes in HRQoL. This study has shown changes in sexuality, body image and HRQoL over time in patients above age 45 treated for hematologic malignancies. One month after treatment all three areas becomes negatively affected, and thereafter the patients' scores recovered to a great extent regarding these issues within 6 months. Sexuality and body image seem to be important aspects of HRQoL for these patients and need to be integrated in the cancer rehabilitation during and after treatment.

Abstract [en]

Background: Longitudinal studies examining sexuality, body image and health-related quality of life (HRQoL) in middle-aged and elderly patients treated with chemotherapy or chemoimmunotherapy for hematologic malignancies are lacking. The aim of this study was to describe and explore changes in sexuality, body image and HRQoL in patients treated

for hematologic malignancies, from baseline until twelve months after treatment.

Body Image Scale (BIS) and The European Organization for Research and Treatment of Cancer Quality of Life questionnaires (EORTC QLQ-C30, version 3). Descriptive- and non-parametric statistics were used.

Results: One month after treatment scores were lowered regarding sexual interest (P = 0.005), sexual function (P = 0.031), sexual satisfaction (P = 0.016, P = 0.004) and sexual relationship. After six months the patient reported scores had returned almost entirely to baseline scores, except for sexual relationship. At 12 months, sexual relationship was still negatively affected. Body image was reported to be affected in a low extent during

the study period. After six and 12 months, body image was reported to not be affected at all by 50% and 53%, respectively. However, women reported body-image to be more affected than men at one (P = 0.01) and 12 months (p = 0.021). Regarding HRQoL, patients reported gradually statistically significant improved scores during the study period.

Conclusion: In this study, sexuality, body image and HRQoL became negatively affected in patients with hematologic malignancies 45 years and older during treatment. Improvements were gradually seen after treatment, but the scores regarding sexual relationship were still affected after one year. Although sexual interest was reported to be low this finding highlights the need of support to these patients regarding sexuality during follow-up care. Furthermore, body image was more affected in women than in men indicating that interventions should be adjusted for sex. This was a small study and future studies with larger sample are needed.

Abstract [en]

Background: Sexuality in relation to Health- Related Quality of Life (HRQoL) is mostly studied with younger patients as participants who have undergone bone marrow transplantation and concerns fertility and/or sexual function. However, patients with hematologic malignancies such as DLBCL,CLL or AML most often are above their fifties and are treated with chemo- or chemoimmunotherapy.

Objective: The aim was to examine how sexuality and HRQoL was affected in patients with hematologic malignancies, at baseline compared to one month after chemo- or chemoimmunotherapy.

Results: Thirty-two patients responded. The importance of sexuality, sexual desire and sexual ability decreased one month after treatment and distressing symptoms such as feelings of tiredness occurred more frequently, compared to baseline. At the same time improvement in Global health status/QoL as well as affected functions in HRQoL was reported.

Conclusion:

The findings are of significance for nurses in cancer care as it highlights that sexuality and HRQoL needs to be considered also in older patients with hematologic malignancies when fertility issues are of less importance.

Implication for practice:

In order to meet these patients’ needs regarding sexuality and HRQoL the care must provide greater consistency and continuity. One way is to organize the care in a patient-centered way where patients continuously meet a nurse guided by the idea of holistic individual nursing care throughout the care trajectory.

Abstract [en]

The aim of the study was to examine patients’ perceptions of side effects, health-related quality of life (HRQL), generalhealth, and nutritional care among patients receiving home enteral tube feeding (HETF) at two occasions after dischargefrom hospital. Three questionnaires, one study-specific, the Short Form 12 (SF-12) and the Health Index (HI), were sent topatients with HETF (n=62) twice, two weeks after discharge from hospital and two months later. Forty patients respondedtwo weeks after discharge and out of these 29 patients also responded after two months. Data were collected in centralSweden from March 2006 to January 2010. Side effects were common at both points of data collection (70% of thepatients after two weeks and 72% after two month). Patients using bolus feeding reported significantly fewer side effectsthan patients using intermittent feeding. HRQL and HI scores for the total group were low at both points of data collection.The bolus feeding group reported significantly higher physical HRQL and emotional HI than the intermittent feedinggroup did. Most patients were satisfied with the information and support they received from the health care team. Thisstudy has revealed that patients treated with HETF experienced side effects limiting their daily life to a great extent.Differences in HRQL related to feeding methods were found. Individualized support and regular controls are needed inorder to meet patient needs. Bolus feeding may be a suitable feeding method to improve well-being.